Iron supplementation after femoral head replacement for patients with normal iron stores
N. P. Zauber, A. G. Zauber, F. J. Gordon, A. C. Tillis, H. C. Leeds, E. Berman and A. B. Kudryk
Department of Medicine, St Barnabas Medical Center, Livingston, NJ.
OBJECTIVE--To assess the efficacy of oral iron therapy in the recovery of
patients' hemoglobin levels after major surgery. DESIGN--Randomized
controlled trial. SETTING--Private orthopedic practice confined to one
large community hospital. PATIENTS--One hundred seventy consecutive elderly
patients undergoing hip surgery; 75 failed to meet entry hematologic or
medical criteria; 95 were randomized, with 16 withdrawn because of
complications. INTERVENTION--Thirty-seven patients received ferrous sulfate
orally four times a day for the duration of their hospitalization.
Forty-two patients who received no iron supplement served as the control
group. MAIN OUTCOME MEASURES--Changes in hemoglobin levels and reticulocyte
counts over the 2- to 3-week follow-up period. RESULTS--There was no
significant difference in mean hemoglobin levels between the treatment and
control groups (95% confidence interval [CI] for difference of -6.6 to 5.4
g/L). Corrected reticulocyte fractions increased equally in both groups
(95% CI for difference of -9 x 10(3) to 2 x 10(-3). The study was designed
to detect a difference in mean hemoglobin levels of 8.5 g/L or greater or a
difference in mean reticulocyte fraction of 10 x 10(-3) between the two
groups with a power of 0.80 at the .05 (two-sided) level of significance.
CONCLUSION--The administration of oral iron supplements to elderly, healthy
orthopedic patients postoperatively did not hasten the recovery of
hemoglobin levels, provided adequate tissue iron stores were present.
